Henoch Schönlein Purpurası tanılı hastaların Epidemiyolojik, Laboratuvar ve Klinik özelliklerinin değerlendirilmesi, 7 Yıllık tek merkez deneyimi

Öz

Amaç: Henoch Schönlein Purpurası (HSP), çocukluk çağının en sık görülen küçük damar vaskülitidir. Başta cilt olmak üzere tüm sistemleri tutabilir. Etiyolojisi henüz net olarak bilinmemekle birlikte, üst solunum yolu enfeksiyonları ve ilaçların hastalığı tetikleyebileceği düşünülmektedir. Bu çalışmada, HSP tanısı alan hastaların epidemiyolojik ve klinik özellikleri ile laboratuvar bulguları incelenerek, laboratuvar ve klinik bulgular arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntemler: Çalışmada, 01.01.2012–10.04.2019 tarihleri arasında Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Polikliniğine, çocuk acil servisine başvuran ya da çocuk hastalıkları servisinde yatarak tedavi gören HSP tanısı alan 127 çocuk hasta, retrospektif olarak hastane sistemi üzerinden bilgisayar ortamında incelendi. Bulgular: Hastaların yaş ortalaması 7.5 ± 3.4 olup, hastalığın en sık görüldüğü mevsim sonbahar (%32) olarak saptandı. Hastaların yarısında (%50) geçirilmiş üst solunum yolu enfeksiyonu ve %38,3’ünde antibiyotik kullanım öyküsü saptandı. Başvuru anında 106 hastada (%88,3) döküntü, 77 hastada (%64,2) eklem tutulumu, 63 hastada (%52,5) gastrointestinal sistem tutulumu ve 31 hastada (%25,8) böbrek tutulumu saptandı. Yalnızca bir hastada (%0,08) santral sinir sistemi tutulumu mevcuttu. Hastaların lökosit değerleri 5.000–37.000 arasında olup; 79 hastada (%73) C-reaktif protein CRP artışı, 84 hastada (%71,1) lökositoz ve 26 hastada (%22) trombositoz saptandı. C3–C4 düzeyi çalışılan 33 hastanın yalnızca 3’ünde (%10) yaşa göre düşüklük saptandı. Mikroskobik hematüri olan 16 kişi (%13,3) saptandı. Çalışmaya katılan 70 hastaya USG yapılmış olup, bu hastaların 13’ünde (%10,8) mezenterik lenfadenit, 5’inde (%4,2) invajinasyon saptandı. Çalışmaya dahil edilen 120 hastanın 91’i (%75,8) hastanede yatarak tedavi aldı. Tedavide en çok kullanılan steroid olmayan antiinflamatuvar ilaçlar (%72,6) idi. Kortikosteroid kullanma oranı ise %39,1 olarak saptandı. Sonuç: Çalışmamızda, multisistemik bir vaskülit olan HSP kendini sınırladı; ancak %9,8 oranında nüks görüldü. Hastalığın akut dönem dışında olası komplikasyonlar ve gelişebilecek nüks nedeniyle uzun dönem takibi önemlidir.

Anahtar Kelimeler

• Henoch Schönlein Purpurası
• etyoloji
• laboratuvar bulguları

Evaluation of Epidemiological, Laboratory and Clinical Characteristics of Patients Diagnosis of Henoch Schönlein Purpura, 7-Years single center experience

Öz

Objective: Henoch Schönlein Purpura (HSP) is the most common small vascular vasculitis of childhood. It can affect allsystems, especiallythe skin. Although its etiology is not yet clearly known, it is thought that upper respiratory tract infections and drugs may trigger the disease. In this study, it is aimed to evaluatet he relationship between laboratory and clinical findings by examining the epidemiological, clinical features and laboratory findings of patients diagnosed with HSP. Methods: In this study, 127 pediatric patients diagnosed with HSP who applied to Zonguldak Bülent Ecevit University Faculty of Medicine Child Health and Diseases polyclinic, pediatric emergency service or treated as inpatients in the pediatrics department between 01.01.2012 and 10.04.2019 were retrospectively examined in a computer environment through the hospitalsystem. Results: The average age of the patients was 7.5 ± 3.4 and the mostcommon seaso nwas autum (32%). Half of thepatients (50%) had a history of upperrespiratorytractinfectionand 38.3% had a history of antibioticuse. At the time of admission, 106 patients (88.3%) had rash, 77 patients (64.2%) had join involvement, 63 patients (52.5%) had gastrointestinal system involvement and 31 patients (25.8%) had kidney involvement. Only one patient (0.08%) had central nervous system involvement. The white blood cell values of the patients are between 5.000-37.000; increased CRP in 79 patients (73%), leukocytosis in 84 patients (71.1%), and thrombocytosis in 26 patients (22%). C3-C4 level was found to be low in 3 patients (10%) compared to age.16 patients (13.3%) had microscopic hematuria. USG was performed in 70 patients who participated in thestudy, 13 (10.8%) of thesepatients had mesenteric lymphadenitis and 5 (4.2%) of intussusception. Ofthe 120 patients included in thestudy, 91 (75.8%) received inpatient treatment. The most commonly used treatment was non-steroidal anti-inflammatory drugs (72.6%). Corticosteroid use rate was found to be 39.1%. Conclusion: HSP, a multisystemic vasculitis, limiteditself in ourstudy, but recurrence was observed at a rate of 9.8%. Longterm followup is important due to possible complications and possible recurrence outside the acutephase of thedisease.

Anahtar Kelimeler

• Henoch Schönlein Purpura
• etiology
• laboratory findings.

Kaynakça

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